| ABSTRACT
Objective
 To provide physicians
and the general public with a responsible assessment of management approaches
to temporomandibular disorders.
Participants
A non-Federal,
non-advocate, 15-member panel representing the fields of clinical dentistry,
medicine, surgery, cellular and molecular biology, epidemiology, bioistatistics,
immunology, behavior and social sciences, pain management, and tissue engineering
presented data to the panel and a conference audience of 1083.
Evidence
The literature
was searched through Medline and an extensive bibliography of references
was provided to the panel and the conference audience. Experts prepared
abstracts with relevant citations from the literature. Scientific evidence
was given preference over clinical anecdotal experience.
Consensus Process
The panel, answering
predefined questions, developed their conclusions based on the scientific
evidence presented in open forum and the scientific literature. The panel
composed a draft statement that was read in it's entirety and circulated
to the experts and the audience for comment. Thereafter, the panel resolved
conflicting recommendations and released a revised statement at the end
of the conference. The panel finalized the revisions within a few weeks
of the conference.
Conclusions
Consensus has not
been developed across the practicing community regarding which TMD problems
should be treated, and when and how they should be treated. The preponderance
of the data do not support the superiority of any method of initial management
of most TMD problems. The efficacy of most treatments approaches is unknown
as most have not been adequately evaluated in long- term studies and virtually
none in randomized controlled trials. Although noninvasive therapies are
clearly preferred for the vast majority of TMD problems, a small percentage
of patients who have persistent and significant pain and dysfunction and
for whom more conservative treatment has failed may be considered for surgical
intervention. Professional education is needed to ensure proper and safe
practice in the treatment of TMD, especially with regard to pharmacological,
surgical, and behavioral approaches.
| NIH Consensus Program Information Center |
P.O. Box 2577
Kensington MD 208791
1-888-NIH- CONSENSUS (644-2667 )
FAX ( 301 ) 816-2494
This draft summary and the full text of
other NIH statements are also available online at:
http://text.nlm.nih.gov/nih/nih.html
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